Medicare threatening hospitals

Thanks to MSSP Nexus Blog for pointing out this story. In today's New York Times, there is a story describing a significant policy change directed at hospitals. Of course, this will save Medicare millions of dollars, but what are the unintended consequences of this policy?

Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.” Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.

In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products. The new policy — one of several federal initiatives to improve care purchased by Medicare, at a cost of more than $400 billion a year — is sending ripples through the health industry.

Now, don't get me wrong. I definitely agree with the intent of this idea. There are definitely some hospital infections that could be prevented, and it's been well documented the impact of medical errors during a hospital stay. I understand why patient advocate groups are happy with this policy decision.

With regard to preventing falls, does that mean that hospitals will have to utilize bed restraints more - because in the middle of the night, sometimes patients are confused and don't know that they're trying to get out of bed. Restraints are already a no-no according to some regulatory agencies.

When it comes to preventing infection, I see more unnecessary testing being done to prove that an infection was obtained before hospitalization. What will be the cost of this? In addition, I see even more increased use of antibiotics, which will further increase the resistance of organisms - and complicating the treatment of infections in the future.

So, while the government's intent is noble, I'm afraid of what the unintended consequences will be. If the government wants people to be accountable, they should start cleaning up their own house first. Of course, we know that will never happen...